Retractor and modular extensions and instruments

Abstract

A surgical retractor system including a retractor tube, one or more modular independent retractor extension clips removably engageable with the retractor tube to deflect and minimize tissue creep, and a deployment instrument for deploying and recovering retractor extension clips.

What is claimed is: 
     
         1 . A surgical retractor system comprising:
 (i) a surgical retractor having an elongate body bounded by a proximal end and a distal end, and at least one slot positioned through a wall of the body at a point between the proximal and the distal ends,   (ii) an extension clip having a flared blade, and a mounting means for releasable engagement with the at least one slot of the surgical retractor, the mounting means comprising one or more of a spring type fitting that is actuatable between open and compressed configurations, an interference fitting, a compression fitting, and a snap fitting; and   (iii) a deployment instrument comprising
 an instrument body with a releasable actuation means for engaging the mounting means of the extension clip and for one of affixing or releasing the extension clip in relation to the surgical retractor slot, the actuation means adapted to direct locking engagement of the extension clip mounting means with the surgical retractor, the actuation means comprising one or more of a releasable gripper for grasping and compressing a spring type fitting, and a biasing means for effecting one or more of compression and snap fitting engagement; and 
 an actuator handle in operable communication with the releasable actuation means of the instrument body 
    wherein the system is adapted for engagement of the extension clip with the surgical retractor body slot to mount the extension in a locked position for extension of the blade toward or outside of the distal end of the surgical retractor body,    whereby, when fixed to the surgical retractor, at least a portion of the extension blade is positioned to contact soft tissue adjacent the distal end of the surgical retractor and thereby minimize tissue creep into the surgical retractor.   
     
     
         2 . A surgical retractor system according to  claim 1 , the mounting means of the extension clip comprising a spring-type interference fitting that is adapted to be actuated between open and compressed configurations, wherein in the compressed configuration, the mounting means can be passed through the surgical retractor slot, and in the open configuration the mounting means is retained in the surgical retractor slot by interference fitting, the extension clip mounting means comprising opposing flexible tabs that are proximal to the distal blade, each tab comprising a hook that includes a pull out stop for interference with the surgical retractor wall when inserted in the slot, the tabs being separated from each other by an open aperture, the mounting means being actuatable by flexion of the tabs within the aperture to move the hooks toward each other in a compressed configuration and released to return to an open configuration, the actuation allowing for passage of the hooks through the slot; and
 wherein the actuation means of the deployment instrument includes a releasable gripper comprising opposing grips that are engageable with the extension clip mounting means, the handle comprising a trigger that alternately directs the action of the opposing grips between open and closed configurations, whereby the releasable gripper actuates the mounting means between open and closed configurations to facilitate passage of the mounting means hooks through the surgical retractor slot.   
     
     
         3 . A surgical retractor system according to  claim 2 , wherein the gripper operates by reciprocation of at least one of the opposing grips, the reciprocation being along one of an axis defined along the surgical retractor body between its proximal and distal ends, and an axis that is transverse to the axis along the surgical retractor body between its proximal and distal ends. 
     
     
         4 . A surgical retractor system according to  claim 2 , the surgical retractor comprising a generally cylindrical or ellipsoid elongate body defining a lumen between its proximal and distal ends and comprising at least one slot disposed through the elongate body toward the distal end. 
     
     
         5 . A surgical retractor system according to  claim 1 , the mounting means of the extension clip comprising a locking tab affixed by a tab arm and extending from a back side of the extension clip, the tab arm comprising locking divots on opposing sides of the tab arm, and
 the surgical retractor comprising a generally cylindrical or ellipsoid elongate body defining a lumen between its proximal and distal ends and comprising at least one slot disposed through the elongate body toward the distal end, the slot being variably dimensioned along a length between the proximal and distal ends of the surgical retractor, the variably dimensioned slot comprising a distally oriented portion and a proximally oriented portion, the proximally oriented portion having a width dimension that is smaller than a width dimension of the distally oriented portion and the proximally oriented portion comprising on each of opposing internal side edges of the wall one or more nubs adapted for interfitting with the locking divots on the locking tab arm of the extension clip; and   wherein the deployment instrument operates by guiding and then directing the locking tab of the extension clip into engagement with the distal portion of the slot, then guiding the extension clip proximally until the arm of the locking tab engages with the proximal portion of the slot, whereby the extension clip is releasably locked to the surgical retractor by engagement between the locking divots and nubs, and is prevented from pull out by interference between the locking tab and the surgical retractor body.   
     
     
         6 . A surgical retractor system according to  claim 5 , the deployment instrument comprising scissor like handles at a proximal end, and oriented distally, opposing arms that include an insertion arm and a biasing arm, the handles and the insertion and biasing arms being joined by a hinge positioned therebetween, the biasing arm further comprising a distal biasing means that is adapted to be compressed against the surgical retractor wall when opposite the slot, whereby engagement between the mounting means of the extension clip and the slot being initially directed by squeezing the handles. 
     
     
         7 . A surgical retractor system according to  claim 1 , the mounting means of the extension clip comprising a locking tab affixed by a tab arm and extending from a back side of the extension clip, the tab arm having a cross sectional shape from distal to proximal that is conical or frustoconical, and
 the surgical retractor comprising a generally cylindrical or ellipsoid elongate body defining a lumen between its proximal and distal ends and comprising at least one slot disposed through the elongate body toward the distal end, the slot being variably dimensioned along a length between the proximal and distal ends of the surgical retractor, the variably dimensioned slot comprising a distally oriented portion and a proximally oriented portion, the distally oriented portion having a greater width dimension than a width dimension of the proximally oriented portion, the proximally oriented portion tapering from the distally oriented portion in a shape that is conical or frustoconical;   wherein the deployment instrument operates by guiding and then directing the locking tab of the extension clip into engagement with the distal portion of the slot, then guiding the extension clip proximally until the arm of the locking tab engages with the proximal portion of the slot into frictional engagement, whereby the extension clip is releasably locked to the surgical retractor by engagement between the tapered portions of the slot and the locking tab arm, and is prevented from pull out by interference between the locking tab and the surgical retractor body.   
     
     
         8 . A surgical retractor system according to  claim 7 , the deployment instrument comprising scissor like handles at a proximal end, and oriented distally, opposing arms that include an insertion arm and a biasing arm, the handles and the insertion and biasing arms being joined by a hinge positioned therebetween, the biasing arm further comprising a distal biasing means that is adapted to be compressed against the surgical retractor wall when opposite the slot, whereby engagement between the mounting means of the extension clip and the slot being initially directed by squeezing the handles. 
     
     
         9 . A surgical retractor system according to  claim 1 , the mounting means of the extension clip comprising at least two vertically separated hooks directed proximally and extending from a back side of the extension clip, wherein at least one of the hooks comprises a locking flange that is directed proximally and is positioned distally on the extension clip,
 the surgical retractor comprising a generally cylindrical or ellipsoid elongate body defining a lumen between its proximal and distal ends and comprising one of at least one slot and two or more slots that are vertically separated, the one or more slots disposed through the elongate body and positioned toward the distal end,   wherein the deployment instrument operates by guiding and then directing at least one of the at least two vertically separated hooks into engagement with at least one slot, whereby snap fit locking of the distal locking flange to one of a slot or the wall of the surgical retractor at its distal end is achieved by actuating the deployment instrument to rotate the extension clip within the lumen in a distal direction until the distal locking flange contacts and snaps on to the slot or the distal end of the tubular body of the surgical retractor.   
     
     
         10 . A surgical retractor system according to  claim 1 , the mounting means of the extension clip comprising at least two vertically separated hooks directed proximally and extending from a back side of the extension clip, and at least one distally positioned locking flange directed proximally,
 the surgical retractor comprising a generally cylindrical or ellipsoid elongate body defining a lumen between its proximal and distal ends and comprising at least two vertically adjacent slots disposed through the elongate body and positioned toward the distal end,   wherein the deployment instrument operates by guiding and then directing the at least two vertically separated hooks into engagement, respectively, with the at least two vertically separated slots, whereby snap fit locking of the distal locking flange to the wall of the surgical retractor at its distal end is achieved by actuating the deployment instrument to rotate the extension clip within the lumen in a distal direction until the distal locking flange contacts and snaps on to the distal end of the tubular body of the surgical retractor.   
     
     
         11 . An extension clip for a surgical retractor comprising:
 a body comprising at a proximal end a mounting means for releasable engagement with at least one slot of the surgical retractor, the mounting means comprising one or more of a spring type fitting that is actuatable between open and compressed configurations, an interference fitting, a compression fitting, and a snap fitting, and at a distal end a flared blade   wherein the extension clip is adapted for engagement with the surgical retractor slot in a releasably locked position for positioning the blade toward or outside of a distal end of the surgical retractor,   whereby, when fixed to the surgical retractor, at least a portion of the extension blade is positioned to contact soft tissue adjacent the distal end of the surgical retractor and thereby minimize tissue creep into the surgical retractor.   
     
     
         12 . An extension clip according to  claim 11 , the mounting means of the extension clip comprising a spring-type interference fitting that is adapted to be actuated between open and compressed configurations, wherein in the compressed configuration, the mounting means can be passed through the surgical retractor slot, and in the open configuration the mounting means is retained in the surgical retractor slot by interference fitting, the extension clip mounting means comprising opposing flexible tabs that are proximal to the distal blade, each tab comprising a hook that includes a pull out stop for interference with a wall of the surgical retractor when inserted in the slot, the tabs being separated from each other by an open aperture, the mounting means being actuatable by flexion of the tabs within the aperture to move the hooks toward each other in a compressed configuration and released to return to an open configuration, the actuation allowing for passage of the hooks through the slot; and wherein the mounting means is actuatable between open and closed configurations to facilitate passage of the mounting means hooks through the surgical retractor slot. 
     
     
         13 . An extension clip according to  claim 11 , the mounting means of the extension clip comprising a locking tab affixed by a tab arm and extending from a back side of the extension clip, the tab arm comprising locking divots on opposing sides of the tab arm,
 wherein the arm of the locking tab is engageable with a surgical retractor slot that is variably dimensioned along a length between proximal and distal ends of the surgical retractor, the variably dimensioned slot comprising a distally oriented portion having a width dimension that is greater than a width dimension of a proximally oriented portion,   whereby upon its passage into the distally oriented slot portion and proximal translation into the proximally oriented slot portion, the extension clip is releasably locked to the surgical retractor, and is prevented from pull out by interference between the locking tab and the surgical retractor body.   
     
     
         14 . An extension clip according to  claim 11 , the mounting means of the extension clip comprising a locking tab affixed by a tab arm and extending from a back side of the extension clip, the tab arm having a cross sectional shape from distal to proximal that is conical or frustoconical, wherein the arm of the locking tab is engageable with a surgical retractor slot that is variably dimensioned along a length between the proximal and distal ends of the surgical retractor, the variably dimensioned slot comprising a distally oriented portion and a proximally oriented portion, the distally oriented portion having a greater width dimension than a width dimension of the proximally oriented portion, the proximally oriented portion tapering from the distally oriented portion in a shape that is conical or frustoconical;
 whereby upon its passage into the distally oriented slot portion and proximal translation into the proximally oriented slot portion, the extension clip is releasably locked to the surgical retractor, and is prevented from pull out by interference between the locking tab and the surgical retractor body.   
     
     
         15 . An extension clip according to  claim 11 , the mounting means of the extension clip comprising at least two vertically separated hooks directed proximally and extending from a back side of the extension clip, and at least one distally positioned locking flange directed proximally,
 wherein the at least two vertically separated hooks are engagable, respectively, with the at least two vertically separated slots in the surgical retractor,   whereby the distal locking flange is releasably locked to a distally positioned edge of the surgical retractor achieved by actuating snap fit locking.   
     
     
         16 . A surgical retractor extension deployment instrument, comprising
 an instrument body with a releasable actuation means for engaging a mounting means of the extension clip and for one of affixing or releasing the extension clip in relation to at least one slot in the surgical retractor, the actuation means adapted to direct locking engagement of the extension clip mounting means with the surgical retractor, the actuation means comprising one or more of a releasable gripper for grasping and compressing a spring type fitting, and a biasing means for effecting one or more of interference, compression and snap fitting engagement; and   an actuator handle in operable communication with the releasable actuation means of the instrument body,   wherein the instrument is adapted for engagement of the extension clip with the surgical retractor slot to mount the extension clip in a locked position for positioning the blade toward or outside of a distal end of the surgical retractor body,   whereby, when fixed to the surgical retractor, at least a portion of the extension blade is positioned to contact soft tissue adjacent the distal end of the surgical retractor and thereby minimize tissue creep into the surgical retractor.   
     
     
         17 . The surgical retractor extension deployment instrument according to  claim 16 , wherein the actuation means of the deployment instrument includes a releasable gripper comprising opposing grips that are engageable with the extension clip mounting means, the handle comprising a trigger that alternately directs the action of the opposing grips between open and closed configurations. 
     
     
         18 . The surgical retractor extension deployment instrument according to  claim 16 , the deployment instrument comprising scissor like handles at a proximal end, and oriented distally, opposing arms that include an insertion arm and a biasing arm, the handles and the insertion and biasing arms being joined by a hinge positioned therebetween, the biasing arm further comprising a distal biasing means that is adapted to be compressed against a surface that opposes a slot that is adapted to releasably receive an extension clip when the handles are one of squeezed and released, wherein the biasing means optionally includes on the biasing arm a torque plate or other planar or curved feature to enhance the contact surface area of the biasing arm. 
     
     
         19 . The surgical retractor extension deployment instrument according to  claim 18 , the instrument adapted for use with a surgical retractor comprising a generally cylindrical or ellipsoid elongate body defining a lumen between its proximal and distal ends and comprising at least one slot disposed through the elongate body toward the distal end, the slot being variably dimensioned along a length between the proximal and distal ends of the surgical retractor, the variably dimensioned slot comprising a distally oriented portion and a proximally oriented portion, the proximally oriented portion having a width dimension that is smaller than a width dimension of the distally oriented portion and the proximally oriented portion comprising on each of opposing internal side edges of the wall one or more nubs adapted for interfitting with the locking divots on the locking tab arm of the extension clip, wherein the deployment instrument operates by guiding and then directing a locking tab of the extension clip into engagement with the distal portion of the slot, then guiding the extension clip proximally until the arm of the locking tab engages with the proximal portion of the slot, whereby the extension clip is releasably locked to the surgical retractor by engagement between the locking divots and nubs, and is prevented from pull out by interference between the locking tab and the surgical retractor body. 
     
     
         20 . The surgical retractor extension deployment instrument according to  claim 18 , the instrument adapted for use with a surgical retractor comprising at least two vertically adjacent slots, wherein the deployment instrument operates by guiding and then directing at least two vertically separated hooks on the extension clip into engagement, respectively, with the at least two vertically separated slots, whereby snap fit locking of a distal locking flange on the extension clip to the surgical retractor at a distal edge is achieved by actuating the deployment instrument to rotate the extension clip until the distal locking flange contacts and snaps on to the distal edge of the surgical retractor.